Orthoptic instrument



May 28, 1935. G. B. WOOTTEN ORTHOPTIC INSTRUMENT Filed July 1, 1933 4Sheets-Sheet l May' 28, 1935. G. B. WOOTTEN ORTHOPTIC INSTRUMENT FiledJuly 1, 1933 4 Sheets-Sheet .2

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4 Sheets-Shee t 4 Filed July l, 1933 /NV/V70R w 6. Bl W00 77.4w

Patented May 28, 1935 PATENT OFFICE ORTHOPTIC A George Bates Wootten,

Canad INSTRUMENT Sudbury, Ontario, 3

Application July 1 1933, Serial No. 678,610 1 7 Claims.

My invention relates to improvements inorthoptic instruments and theobject of the invention is to-provide a single instrument in which isincorporated the various essential devices for overcomingnon-pathological visual weaknesses or disturbances and it consistsessentially of the arrangement and construction of parts as hereinaftermore particularly explained.

Fig. 1 is a perspective view of my apparatus adapted for indicating thecentre line of vision of each eye prior to treatment.

Fig. 2 is a similar view to Fig. 1 with the targets for treatmentinserted in place of the indicating targets.

Figs. 3 and 4 are enlarged perspective details of the manual means foradjusting. the targets.

Fig. 5 is a sectional view through a portion of the mechanismillustrated in Figs. 3 and 4.

Fig. 6 is a sectional detail showing the means for adjusting theposition of the driving motor.

Fig. 7 is a diagrammatic view showing how the virtual position of thetarget is displaced from the actual position.

Fig. 8 illustrates an alternative construction in which prisms areemployed in place of a reflector for displacing the position of thetarget.

Figs. 9 and 10 are enlarged sectional details of the construction shownin Fig. 8.

'Fig. 11 is a diagrammatic view corresponding to Figs. 8, 9 and 10showing how the virtual position of the target is displaced from theactual position.

Fig. 12 is a perspective view of my device with a revolving targetapplied thereto.

Fig. 13 is a sectional view showing a drive for the revolving target.

Fig. 14 is a plan view of the motor shown in Fig. .13 and the reversing.clutch- Figs. 15, 16 and 17 are views of stationary targets and targetcarriers.

Fig. 18 is a'detail view showing a means of in-- terchanging the targetsin the target carrier.

Fig. 19 is a detail of the driving gears shown in Fig. 4 and whichengage the rack 31.

In the drawings like characters of reference indicate correspondingparts.

I indicates the base of my machine the upper faceof which is inclined toform a table I An arch 2 isprovided with a horizontal portion forming ahead rest 3 having the nasal recess 4 and lens orifices 5 and 6 in whichthe lenses 5 and 6 are suitably secured. The sides 3 and 3 of the arch 2(see Figs. 1 and 2) incline inwardly and are each provided on theirinner face with pockets for receiving targets as will hereinafterappear. The foot of each portion 3 and 3 resting uponand secured to theinclined table also forms a slotted opening 4.

A pan 1 is inverted T shape in form, the lower edge of the inverted headbeing provided with an 5 edge rib 1 the opposite edge of the arms of theT being provided with edge ribs 7. The body of the inverted T extendsupward and is provided with a central longitudinal slot 8 and slots 9and I0 adjacent each edge of the T body. A securing 10 bolt 8 extendsthrough the central ,slot 8 and 9 and Mi securing bolts extendingthrough the slots 9 and I 0.

r A square stud II is carried by the head rest.

A mirror I2 is provided with a sleeve l2 through which extends arectangular orifice in which fits the stud ll being secured thereon by aset screw or other suitable device.

A slot I3 is formed in each end wall of the base I. A bracket I4 isprovided with a cylin- 20 drical upper end having a cylindrical orifice.The lower portion of the bracket I4 is preferably flattened and providedwith a cross rib 14 fitting the slot l3 and slidable therein. A setscrew extends through'the lower portion of the bracket I4 and the slotl3 into clamping piece. l6? which is also slidable in the slot I 3 whenthe set screw [6' is loosened. u

A standard 11. is provided with a cylindrical lower end turnably held inthe cylindrical portion of the bracket l4 and held in its adjustedposition by a set screw 18. The standard I! is provided with ahorizontalupper end I'I terminating in a vertical bearing sleeve I1 thelower portion of which is reduced as indicated at-ll'.

A vertical shaft I9 is journalled in the bearing l1 and has secured toits upper end a bevel gear 20 and to its lower end a bevel gear 2|.

An arm 22 is provided with a sleeve end 22 which is swung on the portionI'I' to assume any desired position in which it is held by the set screw22. A double bevel gear 23 is provided one portion of which meshes withthe bevel gear 2|. The gear 23 is mounted upon a stud shaft 23 carriedby the arm 22.

The outer end of the arm 22 is provided with a bearing 24 from whichextends an arm extension 24 having at its outer end a bearing 25. Ashaft 26 is journalled in the bearings 24 and 25. A bevel gear 21 issecured to the shaft 26 at its inner end and meshing with the otherportion of the double gear 23.

A crown gear 28 is secured to the outer end of the shaft 26. A bracket29 forms part of the extension 24 in which is secured a stud shaft 29 onwhich is mounted a combined bevel and straight gear 36 and 3 l.

A hand wheel 32 is secured to a shaft 32* journalled on a bearing 33forming part of the standard H. A bevel gear 34 is secured to theopposite end of the shaft 32 and meshing with the bevel being indicatedin Fig. '1.

The slide is movable longitudinally on the slideway formed by theparallel ribs 1 and 1 and is provided with a rack 31 with which thestraight gear 3| meshes.

In order to locate the location of the centre lines of vision, by meansof imaginary lines extending between the actual position of the arrow 35and the virtual image of the arrow 36 indicated by dotted arrow andbetween the actual position of the arrow 35 andthe virtual image of thearrow 36 indicated by the dotted arrow. I insert the slides .35 and. 36in their slideways as shown in Fig. l, the patient looking through thelenses 5 and 6 adjusts the position of the slide 35 by means of the handwheel 32 until the arrow 35 appears. The slide 36 is then adjusted untilthe virtual image of the arrow 36 appears in transverse alignment withthe arrow 35*. This virtual image of the arrow target 33 on the slide 35is produced by means of the mirror l2 reflecting the image of the arrow3659f the slide 36, such image reflected by the mirror then appearing tothe eye at 36 on the slide 35 when viewed through the lens 5 asillustrated in Fig/'7. In this figure the dashed line A represents theline of reflection of the arrow 36 to'its reflected position on themirror I2. The dashed line B represents the line of vision from the lens5 to the reflection of the image in the mirror [2 and the dotted line C,which is the line B produced, an imaginary line' of vision along whichthe virtual imageappears at 36 on the slide 35 thus displacing thevisual perception of the stationary target from its actual to itsvirtual position. The position of the slide is then noted on thegraduations 38 which indicates the position of the centre line of visiontransversely. The apparent position of the arrow 36 on the slide 35 isobtained in-the same manner as described in connection with the arrow36*.

The slide 35 is also adjusted manually until the arrow 35 is in a linewith the virtual image of the arrow 36 which position is indicated bythe graduations 38 (see Fig. l).

I will now refer to Fig. 2. After the position of the centre lines ofvision have been found as ,above described their point of intersectionbeing the position of rest, and the positions on the graduated scales 38and 38 noted, the slides 35 and 36 are withdrawn from their guidewaysand replaced by similar slides 39 and 40 which form carriers for thetargets 4| and 42 which are in the form of a spot on a black ground sothat all other points but the target in the field of vision are blackthus providing a target having a. maximum intensity of light rays, suchintensity being varied by the incandescent lights indicated at 43 and 44operated by a rheostat control switch which I have not shown beingcommonly used.

Ihe slides 39 and 46 are provided with graduated scales 39* and 40*which correspond to the scales 38 and 38 so that the targets 4i and 42may be placed immediately and accurately in tion.

After the position of the centre lines of vision have been found meansmay be provided for building up the mental power of the patient to fuseobjects. This may be done in various ways either by providing astationary target of one color and the movable target of anothercontrasting color so that when the centre lines of vision are in aposition of rest these colors should blend to form a secondary color. Ifthe colors do not blend it is an indication that the sight of onev eyeis being suppressed and that the other eye functions alone and thereforeonly one color is seen.

By the use of two targets of contrasting color one before either eyetogether with variable illumination for either target provides a newmeans of creating, measuring and developing fusion consciousness.

. Similar results may be obtained by employing a stationary target and arevolving target as illustrated in Figs. 12, 13 and 14. In these figures45 is the target carrier having longitudinal edge ribs to form aclearance, space between the surface of the table and the targetcarrier. An aperture 45 is formed in the carrier and a bearing, 45 islocated centrally beneath the aperture. A shaft 46 is journalled in thebearing 45 the upper end of which may be square. A-disc 41 is providedwith a hub 41 having a squared orifice into which the squared end of.the shaft 46 fits. A driving shaft 48 is mounted in bearings 49 carriedby the carrier 45. A bevel gear 50 is secured on the shaft 46 and 5| isa bevel gear secured on the shaft 48 and meshing with the bevel gear 50.The numeral 52 indicates a driving motor and 53 the motor shaft on whichis slidably mounted the sleeve 54 feather keyed to the shaft. The directand reverse drive gears 55 and 56 are carried by the sleeve 54. A shortshaft 51 is journalled in a bearing 58 and connected by a flexible shaft59 to the shaft 48. A bevel gear 60 is secured to the shaft 51 andmeshing either with the gear 55 or 56 as the sleeve 54 is moved ineither one direction or the other by the lever In using this deviceafter the point of convergence has been found as above described thetarget carrier 45 and target 41 is inserted coacting with a stationarytarget such as indicated at 42, Fig. 2.

If there is no suppression of the poorer eye the revolving target willbe seen revolving ina superimposed position over the reflectedstationary target. If the poorer'eye is suppressed the reflectedstationary target will alone be seen.

The effort on the part of the patient to see the revolving target tendsto increase his fusional faculty. In order to adapt to the position ofrest ground to give the maximum amountof light stimulus to the eye. Themovable target 42 and its carrier is then reciprocated by means of themotor 52 the shaft 53 of which (see Fig. 2) is provided with a disc S2secured thereto and provided with a radial row of holes 62 A pitman rod63 is pivotally connected to the end of the carrier 40 as indicated at64 and connected to the disc at its opposite end by a crank pin 65secured in any one of the holes 62 in accordance with the length of thestroke desired.

As soon as fusion is experienced by the patient use is made of the handcontrol operating the sliding target to slightly displace it from theposition of rest. As fusional range is developed we can then exercisewithin that range by means of the motor.

By the reciprocating of the movable target the fused stationary andmovable targets tend to break aw y, the reciprocating movement of thetarget being at first very short so as to gradually train the eyes tohold the fusion. The movement is gradually increased to lengthen thestroke until the eyes are brought back beyond the position of normalconvergence, thereby strengthening the muscles until they are able tofunction normally and at the same time build the reserve so that theyare enabled to carry out these functions comfortably.

In cases where there is vertical imbalance between the two eyes theoperation is the same. The position of the targets is adjusted up ordown. That is in case of the left eye being higher the stationary targetmay be adjusted upward or the movable target downward and in the case ofthe right eye being higher the movable target may be adjusted upward orthe stationary target downward.

In order to gradually exercise the eye when there is vertical imbalancethe tray, by loosening the nuts 9* and Ill, may be adjusted to aninclined position so the target carrier 40 and target 42 may bereciprocated in an inclined direction thereby permitting a very smallrange of vertical displacement in association with the longitudinalmovement so that the eye can be trained very gradually back to normal.

Together with the above results provision may be made for the use ofstereoscopic pictures, as an auxiliary method of treating suppression,while providing adaptation of either picture vertically or horizontallyto compensate for any muscular imbalance between the two eyes. A largeinward displacement is provided by the mirror in front of one eye andthe vertical adjustment by the raising and lowering of either picture.

An auxiliary method may be provided for treating amblyopia by using thelarge rotating disc before that eye with the septum in placeand thelight completely shut oil from the better eye. This is also used todevelop motility of the muscles in an eye which, through disuse, haslost the function of the muscles.

When this method is employed a septum 66 is provided supported on thestud '1 I (see Fig. 12). A large disc 41* is mounted on the stud shaft46 illustrated in Fig. 13. The position of the carrier is adjusted sothat the disc is on one side of the septum and is driven by themechanism illustrated in Fig. 13. A target 41 is placed on the disc asindicated.

By removing the septum and adjusting the target carrier so that the discassumes a central position an auxiliary method is provided forexercising, binocularly, muscular incoordination.

Another auxiliary method for treating, binocularly, muscularincoordination is to-place the for the vertical position of fusion pointof the targets, the slide being provided with a transverse slot in whichthe motor is adjusted by means of the nut 69 (see Fig. 6) to compensatefor the horizontal position of the fusion point.

By means of the targets illustrated in Figs. l5,

16 and 17 exercises may be provided with the eyes directed centrally orboth to one side or the other, or both raised or both lowered.

In Figs. 8, 9, 10 and 11 I show an alternative construction in which Iemploy prisms instead of a reflector for displacing the actual positionof the target to a. virtual position to conform to the normalconvergence of the central lines of vision. In this construction Iemploy beneath the lenses 5 and 6 prisms HI and II held in a,

frame 12 which is pivoted on the lens holding ring 13 and adjustablyheld in a spring catch so that prisms of various thickness may beemployed. A septum 14 divides the field of vision centrally between theeyes. In this construction the stationary target carrier 19 issupported'upon the table in longitudinal alignment with the movabletarget carrier 80 so as to coact with the prisms.

By this means in cases of high divergence the prisms afford a greaterfield for outward displacement of the targets. Also by the use of theprisms ordinary stereoscopic pictures and charts may be used without thepicture being reversed or laterally transposed as is necessary with themirror. The targets may be removably held in the target carrier asindicated in Figure '18. In this figure 15 is the target and 16 thecarrier. The lower portion of the target is extended annularly to form asurrounding flange 15 The target carrier is provided with an aperture 16the lower portion of which is enlarged to the diameter of the targetflange Li to form a flange 76 against which the flange 15 fits when thetarget is inserted. In the enlarged portion of 'the orifice Hi is anannular groove 11 containing a split N spring retaining ring 18 engagingthe lower face of the flange 15*. By this means the targets may beinterchanged whenever desired.

From this description it will be seen that I have devised an instrumentby which all treatments which are desirable and essential for theimprovement of the vision may be given and the form of the several stepsof treatment varied to relieve the monotony, to more effectively arousethe interest of the patient therein; which provides a 0 greaterflexibility of technique for the practitioner, which provides moreefl'ective means for carrying out each step and combines in one unit thevarious devices to be used. The development of the coordinated functionsare built up simul- 5 taneously and by more effective means, in whichthe indicating of the centre lines of vision is effected so that thetargets may be seen without strain on the eyes of the patient, in whichthe movement of the target may be eifected by direct 70 manual means orthrough the medium of a hand wheel or by means of a driving motor suchas i1- lustrated. I

What I claim as my invention is:

1. Ina device for treating eyes, the combinamotor shaft, a drivingconnection between the shaft and carrier for reciprocating the carrier,-

adjustable means for controlling the length of stroke of the movabletarget, and means for adjusting the position of the motor transverselyto correspond with the transversely set position of the target.

2. In a device for treating eyes, a table, a head rest, alens for eacheye carried by the head rest,

graduated means for locating on the table a point corresponding to thepoint of convergence of the axes of the eyes, a stationary target viewedthrough one lens, a target movably mounted on the table and viewedthrough the other lens, means for producing a virtual image of thestationary target located in the same plane as the movable target, and ascale coacting with each target, the graduations of which correspond tothe graduations of the aforesaid convergence point locating meanswhereby the centre of the movable target and the virtual image of thestationary target automatically coincide with the previously locatedpoint of convergence when placed in the same graduated position.

3. In a device for treating eyes, a lens support, a lens mounted in thesupport and coact-, ing with one eye, a. table,'astationary slideextending edgewise between the table and lens support and on which atarget is represented, a'

movable slide mounted on the table to move transversely to thestationary slide and on which a target isrepresented, a lens alsomounted in the lens support and coacting with the other eye, and amirror coacting with the first mentioned lens and target to provide, onthe movable slide, a stationary virtual image of said first mentionedtarget. to coact with the target of the movable slide.

4. In a device for treating eyes, the combination with a table formingaslide'support, a head rest and lenses mounted in the head rest, of meansfor indicating on the table the point of convergence of the axes of theeyes, such means comprising a stationary and a movable slide s h at anangle one-to the other, pointers extending from two adjacent sides ofthestationary slide and viewed through one lens, similar pointers extendingfrom the complementary sides of the movable slide and viewed through theother lens, means for producing a virtual image of the pointers of thestationary slide on the movable slide in a line with the pointers of themovable slide, and graduations for indicating the'position of theaforesaid indicating slides when indicating the point of convergence ofthe axes of the eyes, a stationary anda movable exercising target slide,each having a spot target thereon and adapted to replace the aforesaidindicating slides and bearing graduations identical to those of theindicating slides so that the centres of the spot target of the movableslide, the virtual image of the spot target of the stationary slide andthe indicated point of convergence are coincident when the spot targetslides, and convergence indicating slides are set in the same graduatedposition.

5. In a device for treating eyes, the combination with a table, amovable slide mounted on the'table, and a head rest and lenses mountedthereon, of a disc revolubly mounted on the slide and forming a darkbackground, a relatively bright spot target located eccentrically on theface of the disc, and means for rotating the disc in all positions ofthe movable slide.

6. In a device for treating eyes, means for locating the point ofconvergence of the axes of the patients eyes, a stationary target, meansfor producing a virtual image of the stationary target in such aposition as to be viewed by one eye, means for instantly and accuratelylocating such virtual image in a position coincident with the previouslyformed point of convergence, and a movable target viewed through theother eye, and means for instantly and accurately placing the centre ofthe movable target in an initial position coincident with the centre ofthe virtual image and the point of convergence in and out of whichposition it is adapted to be intermittently moved. a

'7. In a device for treating eyes, means for locating the point ofconvergence of the axes of the patients eyes, a stationary target, meansfor producing a virtual image of the stationary target in such aposition as to be viewed by one eye, means for instantly and accuratelylocat-.

ing such virtual-image in a position coincident with the previouslyformed point of convergence, and a movable target viewed through theother eye, and means for instantly and accurately placing the centre ofthe movable target in an initial position coincident with the, centre ofthe virtual image and the point of convergence, and means forintermittently moving the movable target in and out of its position ofcoincidence.

GEORGE BATES WOO'ITENL

